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Florida Mutawakkil, RN, works with an OR robotic system at Miami Cardiac and Vascular Institute at Baptist Hospital.

When Paula Graling, MSN, RN, a certified operating room nurse and clinical nurse specialist at Inova Fairfax Hospital in Falls Church, Va., first viewed the latest cutting-edge operating room technology at a conference in Florida 10 years ago, she felt amazed, a little overwhelmed and a tiny bit concerned.

The computers in the laparoscopic surgery suite spoke, announcing when everything was activated and ready. The lighting system dimmed or brightened the room in response to voice commands. Robots held cameras in place. Video monitors showed clear, clean pictures of the simulated model patient and procedure from all angles.

“I sat there in awe,” said Graling, national treasurer for the Association of periOperative Registered Nurses. “The first thing I thought was, ‘I’m never going to get all these things together.’ ”

In the back of her head was another, more unnerving thought: “Am I going to be replaced by this thing?”

Today, she works in a hospital with six “Smart Suites”—also called Endosuites, OR1s and Operating Rooms of the Future, depending on which company makes them—and three robots. Not only has she mastered the new technology, she loves using it. It still amazes her. But she no longer fears it could replace real nurses.

“I’m never going to be replaced,” she said. “The human component is something that can’t be replaced.”

Operating room technology for noninvasive surgery has exploded in the last five years as robots, voice-controlled systems, sophisticated imaging equipment and tracking techniques have been integrated with computer systems to create operating rooms that practically run themselves.

The new technology is expensive, ever-changing and requires more education, but generally it saves time, creates less room for error and—with the machines and monitors in the newest rooms now suspended from ceiling booms—reduces the amount of pushing and lifting nurses must do.

But the best feature of the new technology, perioperative nurses say, is that it leaves them more time to do the most important part of their job, the part no machine can replace: caring and advocating for their patients.

Laparoscopic surgery has expanded to almost every corner of the hospital. Orthopedic, endovascular, ophthalmology, plastic surgery, neurosurgery, urology and general surgeries are commonly performed using minimally invasive procedures. Surgeries that once took 12 hours now take less than three.

Leaps and bounds

As these surgeries have evolved, so has the technology used to perform them. Surgeons use 3-millimeter endoscopes and perform operations using high-resolution cameras and video monitors. Robotic arms hold cameras and light sources in place. Other robots, such as the da Vinci Surgical System, actually perform surgery, manipulated by the physician. With a patient’s permission, surgical procedures can be broadcast to classrooms in the hospital or copied onto DVDs to help educate students or other patients.

The advance in OR technology that nurses perhaps appreciate most has come in the setup and integration of the laparoscopic surgery suite. Perioperative nurses say they expect the new technology to become standard in operating rooms and intensive care units within the next few years, and eventually spread to the rest of the hospital.

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